Warnings about the care bill’s impact on funding ignore the real problem – the sector needs to change its model

 

Earlier this month Nick Kirwan said the care bill could spell financial disaster for care providers. Kirwan argued the legislation will signal the end of private funders currently living in residential care cross-subsidising those funded by local authorities. By his calculation this will take £1bn away from care companies, potentially leading to provider failure and poorer services.

It’s a well-known industry fact that this cross subsidy has been keeping many care providers afloat for years but, in our view, it is high time it came to an end. It’s unsustainable but the reality is local authorities don’t have the money to pay market rates in the current model. So, the model needs to change.

And there lies the crux of the problem. The real threat to care providers in the current environment is their refusal to innovate.

Just look at the facts.

The number of people over 85 has been projected to increase from 1.4m to 3.5m by 2035. Yet the government has less money to support them – local authorities have cut social care spending by around £2.7bn since 2010.

Moving into residential care is still seen as a “distress purchase”, one that happens at times of crisis. Research by Demos last year found that one in four people would refuse to move into a care home. Quality of service is poor and the reputation of the industry is suffering. One in three care homes inspections result in failure and fear of abuse is a key reason why people don’t want to move into care.

There are growing numbers of private funders, as revealed by LaingBuisson, who will demand more. They want a better and de-institutionalised environment in which to live, improved service where they’re treated with dignity and respect, and staff who have time to spend with them.

So what needs to happen? Existing organisational structures and roles should be abolished; there needs to be a greater emphasis on creating a culture based on putting the customer first; and we need to supply a product that meets market demand.

Abolish current organisational structure

In a traditional residential care home setting, there is a hierarchy of roles that are all task-based. For example, care manager with team leaders and care assistants, plus laundry, catering, cleaning, resident activities and other service roles.

This means there could be up to 100 staff to cover all daily activities in an average 60-bed care home. The workforce has very little room for manoeuvre, is totally task-oriented and paid accordingly. Combine this with poor pay, and it’s not surprising the sector experiences high turnover.

At Evermore we’re taking the lessons from the Green House Projectwhere staff have autonomy, become masters of their craft and have real power to advocate.

Change the culture to focus on the customer

In the existing model users of residential care are treated as recipients instead of customers. We need turn to turn this on its head with leaders who inspire and staff who are genuinely committed to ensuring the customer gets to make the decisions, keeps control and continues to contribute.

This can be achieved by focusing on smaller numbers of people and enabling staff to be close to their older compatriots. That way “person-centred” care and other useless jargon can be thrown away as real relationships are fostered.

Respond to market demand

Quite simply older people don’t want to live in a care home. Yet what are their options? Around 3.5 million people aged over 60 wish to buy retirement property, but only 100,000 suitable homes exist.

So what we need is a completely new lifestyle approach – one where older people have their own space but also good company when they need it and support when they want it. A place where they are not alone or isolated, and can continue doing what they love.

All of these changes might seem like an insurmountable task but we disagree. As Einstein said, insanity is doing the same thing over and over again and expecting different results. So we’ve decided to shift instead of tinker.

Sara McKee is founder and director of market innovation at Evermore